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Case Reports
. 2023 Dec 15;19(3):835-838.
doi: 10.1016/j.radcr.2023.11.045. eCollection 2024 Mar.

Liver cirrhosis requiring transplantation in the context of hepaticojejunostomy stricture after a traumatic bile duct injury

André Mascarenhas  1 , Hugo Pinto Marques  2 , João Coutinho  3 , Américo Martins  2 , Fernando Nolasco  2
Affiliations
Case Reports

Liver cirrhosis requiring transplantation in the context of hepaticojejunostomy stricture after a traumatic bile duct injury

André Mascarenhas et al. Radiol Case Rep. .

Abstract

Biliary injury secondary to trauma is frequently associated with long-term complications. Liver transplantation is rarely indicated but might be the best therapeutic option in severe or intractable cases. We report the case of a 19-year-old male referred for liver transplantation due to biliary injury after abdominal trauma. A Roux-en-Y hepaticojejunostomy was initially performed without immediate complications. Anastomotic stricture developed requiring several trials of biliary dilatation and stenting through a percutaneous approach. The presence of liver cirrhosis and the intractability of this complication culminated in the decision of liver transplantation. The authors present clinical course, complications and interventional procedures that were used in a judicious step-up approach.

Keywords: Abdominal trauma; Extrahepatic biliary tree injury; Liver transplantation; Secondary biliary cirrhosis.

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Figures

Fig 1
Fig. 1
Abdominal computed tomography showing dilation of the intrahepatic biliary ducts (black arrows) and portal vein thrombosis (white arrow).
Fig 2
Fig. 2
Magnetic resonance cholangiopancreatography showing the biliary stricture at the site of the anastomosis (white arrow) along with marked dilation of the intrahepatic biliary tree.
Fig 3
Fig. 3
Image at the end of the percutaneous transhepatic biliary drainage procedure.
See this image and copyright information in PMC

References

    1. Thomas MN, Stippel DL. Management of bile duct injuries [Management von Gallengangsverletzungen] Der Chirurg. 2020;91(1):18–22. doi: 10.1007/s00104-019-01060-2. - DOI - PubMed
    1. Krawczyk M, Grat M, Adam R, Polak WG, Klempnauer J, Pinna A, et al. Liver transplantation for hepatic trauma: a study from the European liver transplant registry. Transplantation. 2016;100(11):2372–2381. doi: 10.1097/TP.0000000000001398. - DOI - PubMed
    1. Coccolini F, Kobayashi L, Kluger Y, Moore EE, Ansaloni L, Biffl W, et al. Duodeno-pancreatic and extrahepatic biliary tree trauma: WSES-AAST guidelines. World J Emerg Surg. 2019;14:56. doi: 10.1186/s13017-019-0278-6. - DOI - PMC - PubMed
    1. Schreuder AM, Busch OR, Besselink MG, Ignatavicius P, Gulbinas A, Barauskas G, et al. Long-term impact of iatrogenic bile duct injury. Dig Surg. 2020;37(1):10–21. doi: 10.1159/000496432. - DOI - PMC - PubMed
    1. LeBedis CA, Bates DDB, Soto JA. Iatrogenic, blunt, and penetrating trauma to the biliary tract. Abdom Radiol. 2017;42(1):28–45. doi: 10.1007/s00261-016-0856-y. - DOI - PubMed

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